The Rheumatologist
COVID-19 News
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Axial Spondyloarthritis Resource Center
    • Gout Resource Center
    • Psoriatic Arthritis Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
    • Interprofessional Perspective
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Systemic Lupus Erythematosus Resource Center
      • Rheumatoid Arthritis Resource Center
      • Gout Resource Center
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / Preventing the Onset of Rheumatoid Arthritis: Is It Possible?

Preventing the Onset of Rheumatoid Arthritis: Is It Possible?

June 16, 2020 • By Jason Liebowitz, MD

  • Tweet
  • Email
Print-Friendly Version / Save PDF

ACR BEYOND LIVE—A moonshot concept in rheumatology has long been centered on the question of whether autoimmune disease can be cured. A less frequently posed inquiry, albeit equally important, is: Can the onset of autoimmune disease be prevented in the first place?

You Might Also Like
  • Recent Study Improves Understanding of Preclinical Rheumatoid Arthritis
  • Juvenile-Onset Arthritis Bodes Worse Pregnancy Outcomes
  • ACR/ARHP Annual Meeting 2012: Early Signs of Rheumatoid Arthritis May Appear Outside the Joints
Explore This Issue
July 2020
Also By This Author
  • Sarcoidosis in the Spotlight: Screening, Treatment & More Insights into Sarcoidosis

At the 2020 ACR State-of-the-Art Clinical Symposium, Kevin Deane, MD, PhD, associate professor of medicine and William P. Arend Endowed Chair in Rheumatology Research at the University of Colorado Anschutz Medical Campus, Aurora, provided a thought-provoking lecture on the pathogenesis, prediction and prevention of rheumatoid arthritis (RA), with many insights into this emerging area of research.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

Risk Factors
To start with, Dr. Deane described the concept of pre-clinical RA, which is the state in which an individual is at high risk for the future development of RA, but does not yet show synovitis.

Numerous factors have been demonstrated to have an association with an increased risk for RA, including female sex, family history of RA, exposure to tobacco smoke or occupational dust (e.g., silica), obesity and low vitamin D intake and levels. In addition, genetic risk factors have been identified that place patients at risk for pre-clinical and clinical RA. The term shared epitope refers to a group of alleles within the major histocompatibility complex (MHC), which encode amino acid sequences that predict structural similarities in the human leukocyte antigen (HLA) peptide-binding groove. The shared epitope may contribute up to 40% of the risk of developing RA.1

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

Predictive Factors
Beyond these risk factors, elevations of rheumatoid factor (RF) and antibodies to citrullinated protein/peptide antigens (ACPAs) have been used to identify individuals who may be in the pre-clinical phase of RA when there is not yet concomitant synovitis.

In 2003, researchers from Sweden published a paper in which 83 individuals with RA were identified as having donated blood prior to the onset of any symptoms of arthritis. In these blood samples, which predated the onset of clinical disease, anti-cyclic citrullinated peptide (anti-CCP) antibodies and RFs of all isotypes were found at statistically significantly higher levels than in healthy, matched controls.2

Similarly, in studying more than 200 patients with RA from the Department of Defense Serum Repository, Kelmenson et al. found that IgG ACPA was elevated at a mean of almost 18 years prior to the diagnosis of RA.3

ad goes here:advert-3
ADVERTISEMENT
SCROLL TO CONTINUE

Dr. Deane also discussed ways in which risk factors and antibody status can be used in prediction models to anticipate which patients will develop clinical RA. In studying more than 370 patients with anti-CCP antibodies and/or IgM RF positivity and arthralgias without clinical arthritis, researchers from The Netherlands were able to develop a prediction model that considered family history, alcohol use, symptoms (e.g., duration, location, frequency), reported history of swollen joints, antibody status and other variables. This model was used to classify patients as at low, intermediate or high risk for the development of clinical arthritis.

Pages: 1 2 3 | Single Page

Filed Under: Rheumatoid Arthritis Tagged With: RA Resource CenterIssue: July 2020

You Might Also Like:
  • Recent Study Improves Understanding of Preclinical Rheumatoid Arthritis
  • Juvenile-Onset Arthritis Bodes Worse Pregnancy Outcomes
  • ACR/ARHP Annual Meeting 2012: Early Signs of Rheumatoid Arthritis May Appear Outside the Joints
  • Researchers Work Toward Early ID & Treatment of Rheumatoid Arthritis

ACR Convergence

Don’t miss rheumatology’s premier scientific meeting for anyone involved in research or the delivery of rheumatologic care or services.

Visit the ACR Convergence site »

Simple Tasks

Learn more about the ACR’s public awareness campaign and how you can get involved. Help increase visibility of rheumatic diseases and decrease the number of people left untreated.

Visit the Simple Tasks site »

Meeting Abstracts

Browse and search abstracts from the ACR Convergence and ACR/ARP Annual Meetings going back to 2012.

Visit the Abstracts site »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2022 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)